Serotonin syndrome from combination hydrocodone and cyclobenzaprine in a patient with cerebral palsy.
Vishal BansalMayank ArankePeter VuSaba JavedPublished in: Pain management (2023)
Aim: Serotonin syndrome (SS) is a life-threatening syndrome that occurs with the use of serotonergic drugs, most commonly due to two or more agents. Cerebral palsy is associated with mood disorders, and more commonly pain, with a prevalence of up to 50-80%. Case presentation: A 58-year-old female with cerebral palsy, metastatic malignancy and mood disorder who presented to the emergency department with acute-on-chronic pain, and signs of SS. She was initiated on iv. dilaudid, titrated off oral medications and scheduled for a left-sided sacroiliac joint injection. Results: It was suspected that due to additional doses of hydrocodone and cyclobenzaprine, she developed moderate-SS. Conclusion: Physicians need to be cognizant of comorbidities and uncommon pain medications that can predispose patients to SS.
Keyphrases
- cerebral palsy
- chronic pain
- case report
- emergency department
- pain management
- bipolar disorder
- primary care
- small cell lung cancer
- neuropathic pain
- newly diagnosed
- squamous cell carcinoma
- ejection fraction
- prognostic factors
- risk factors
- intensive care unit
- pulmonary embolism
- patient reported outcomes
- physical activity
- peritoneal dialysis
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation
- adverse drug